Mental Health & Learning Disabilities Today: Area/s for improvement Context - national & local Progress – December forward following NHS management changes within Powys Potential benefits

Mental Health & Learning Disabilities Identified Areas for Improvement: Ensuring out of hours and crisis support when needed Alternatives to admission, with in-patient access when needed Developing integrated services for people with Dementia Extending access to psychological therapies Child and adolescent mental health services

Mental Health & Learning Disabilities Context: National Mental Health (Wales) Measure 2010 Together for Mental Health (2012) Together for Children and Young People Dementia Action Plans Psychological Therapies Implementation Plan

Mental Health & Learning Disabilities Local context: Powys Hearts and Minds: Together for Mental Health in Powys Model for adult mental health services (enhanced primary care; acute care in the community; needs led services for older people; integration) Increase in people living with dementia in the county by 44% by 2021 Integration of services with Powys County Council Change to NHS management arrangements from 1st December (previously 4 health boards managing mental health services within 1 county)

Identified Area for Improvement: out of hours and crisis support Tiered approach Prevention and early intervention: information and advice; psychological therapies; co-ordinated care and treatment planning Alternative to admission: Crisis Resolution Home Treatment Teams and Community Intensive Teams On-call: GP out of hours; local authority Emergency Duty Team/s; nurse on-call; psychiatrist on-call; section 12 doctors; psychiatric and medical emergencies; s 136 Together understanding “intensity” is not frequency in a highly rural area; training Section 12 GPs; training and developing Approved Clinicians from different professions; accredited accommodation/ different approach to a crisis house; technology - Telemedicine and internet services (including for psychological therapies); rigorous and creative care and treatment planning; tackle gaps during the day; extending CRHTTs for older people; alternative places of safety; admission for high physical and mental health needs; role of advanced practitioners

Mental Health & Learning Disabilities Progress to date: December forward due to NHS management changes in Powys Membership (people using services; multiagency) Elements underway in line with national strategy – added benefit of working together

The Potential Benefits to Mid Wales: Mental Health & Learning Disabilities The Potential Benefits to Mid Wales: Sustainable approach in a highly rural area– so people with mental illness can receive appropriate help out of hours Reduced travelling time and delays for patients (and best use of scarce skills) Investment in local services by reducing inappropriate and distant hospital admissions Better care and treatment planning to prevent a deterioration